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Burden of disease attributable to high body mass index: an analysis of data from the Global Burden of Disease Study 2021

Zhou XD 1 , Chen QF 2 , Yang W 3 , Zuluaga M 4 , Targher G 5 , Byrne CD 6 Show all authors , Valenti L 7 , Luo F 8 , Katsouras CS 9 , Thaher O 10 , Misra A 11 , Ataya K 12 , Oviedo RJ 13 , Pik-Shan Kong A 14 , Alswat K 15 , Lonardo A 16 , Wong YJ 17 , Abu-Abeid A 18 , Al Momani H 19 , Ali A 20 , Molina GA 21 , Szepietowski O 22 , Jumaev NA 23 , Kızılkaya MC 24 , Viveiros O 25 , Toro-Huamanchumo CJ 26 , Yen Kok KY 27 , Ospanov O 28 , Abbas SI 29 , Robertson AG 30 , Fouad Y 31 , Mantzoros CS 32 , Zhang H 33 , Méndez-Sánchez N 34 , Sookoian S 35 , Chan WK 36 , Treeprasertsuk S 37 , Adams L 38 , Ocama P 39 , Ryan JD 40 , Perera N 41 , Sharara AI 42 , Al-Busafi SA 43 , Opio CK 44 , Garcia M 45 , Lim-Loo MC 46 , Ruiz-Úcar E 47 , Prasad A 48 , Casajoana A 49 , Abdelbaki TN 50 , Zheng MH 51

Affiliations 

  • 1 Department of Cardiovascular Medicine, the Heart Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
  • 2 Medical Care Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
  • 3 Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
  • 4 Departament of Surgery, Universidad del Valle, Cali, Valle del Cauca, Colombia, United States
  • 5 Department of Medicine, University of Verona, Verona, Italy
  • 6 Southampton National Institute for Health and Care Research Biomedical Research Centre, University Hospital Southampton, and University of Southampton, Southampton General Hospital, Southampton, UK
  • 7 Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
  • 8 Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
  • 9 First Department of Cardiology, University Hospital of Ioannina and Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, 45110, Greece
  • 10 Department of Surgery, Marien Hospital Herne, University Hospitals of the Ruhr University of Bochum, Herne, NRW, Germany
  • 11 Fortis-CDOC Center of Excellence for Diabetes, Metabolic Diseases, and Endocrinology, National Diabetes Obesity and Cholesterol Foundation and Diabetes Foundation, New Delhi, India
  • 12 Department of Bariatric Surgery, University of Montreal, Montreal, Quebec, Canada
  • 13 Nacogdoches Center for Metabolic & Weight Loss Surgery, Nacogdoches Medical Center, Nacogdoches, TX, United States
  • 14 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
  • 15 Liver Disease Research Center, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • 16 Department of Internal Medicine, Ospedale Civile di Baggiovara (-2023), Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
  • 17 Department of Gastroenterology & Hepatology, Changi General Hospital, Singapore
  • 18 Division of Surgery, Tel Aviv Sourasky Medical Center affiliated to Tel Aviv University, Tel Aviv, Israel
  • 19 Weight Management Unit, Royal NMC Hospital, Khalifa City, Abu Dhabi, United Arab Emirates
  • 20 Metabolic and Bariatric, Fatima8h hospital, Tehran, Iran
  • 21 Department of Surgery, USFQ (Universidad San Francisco), Quito, Pichincha, Ecuador
  • 22 Department of Surgery, Ashford and St Peter's Hospital, Chertsey, Surrey, United Kingdom
  • 23 Department Surgical Diseases, Tashkent Medical Academy, Tashkent, Almazar, Uzbekistan
  • 24 Department of Metabolic and Bariatric Surgery, Acibadem Atakent University Hospital, Istanbul, Turkey
  • 25 Department of Metabolic and Bariatric Surgery, Hospital Lusiadas Amadora, Amadora, Lisbon, Portugal
  • 26 Universidad San Ignacio de Loyola, Lima, Peru
  • 27 Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei-Muara, Brunei
  • 28 Surgical Disease and Bariatric Surgery, Astana Medical University, Astana, Aqmola, Kazakhstan
  • 29 Department of Metabolic and Bariatric Surgery, Iranian Hospital Dubai, Dubai, United Arab Emirates
  • 30 Department of Upper Gastrointestinal Surgery, Royal Infirmary Edinburgh, Edinburgh, United Kingdom
  • 31 Department of Gastroenterology, Hepatology and Endemic Medicine, Faculty of Medicine, Minia University, Minia, Egypt
  • 32 Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
  • 33 Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • 34 Liver Research Unit, Medica Sur Clinic & Foundation, Mexico City, Mexico
  • 35 Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
  • 36 Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 37 Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 38 Department of Hepatology, Sir Charles Gairdner Hospital, Perth, Australia
  • 39 Department of Medicine, Makerere University of College of Health Sciences, Kampala, Uganda
  • 40 Department of Hepatology, RCSI School of Medicine and Medical Sciences, Dublin/Beaumont Hospital, Dublin, Ireland
  • 41 Department of Medicine, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
  • 42 Division of Gastroenterology and Hepatology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
  • 43 Department of Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
  • 44 Department of Medicine, Aga Khan University, Nairobi, Kenya
  • 45 Departament of Metabolic and Bariatric Surgery, Tu Opcion Bariatrica/Swiss Hospital, Monterrey, Mexico
  • 46 Department of Surgery, Chinese General Hospital and Medical Center, Manila, Philippines
  • 47 Department of Metabolic, Bariatric and Endocrine Surgery, Fuenlabrada University Hospital, Madrid, Spain
  • 48 Surgical Gastroenterology, Bariatric and Robotic Surgery, Indraprastha Apollo Hospital, New Delhi, India
  • 49 Departament of Esophagogastric and Bariatric Surgery, Hospital del Mar de Barcelona, Barcelona, Spain
  • 50 Department of General Surgery, Alexandria University Faculty of Medicine, Alexandria, Egypt
  • 51 MAFLD Research Center, Department of Hepatology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
EClinicalMedicine, 2024 Oct;76:102848.
PMID: 39386160 DOI: 10.1016/j.eclinm.2024.102848

Abstract

BACKGROUND: Obesity represents a major global health challenge with important clinical implications. Despite its recognized importance, the global disease burden attributable to high body mass index (BMI) remains less well understood.

METHODS: We systematically analyzed global deaths and disability-adjusted life years (DALYs) attributable to high BMI using the methodology and analytical approaches of the Global Burden of Disease Study (GBD) 2021. High BMI was defined as a BMI over 25 kg/m2 for individuals aged ≥20 years. The Socio-Demographic Index (SDI) was used as a composite measure to assess the level of socio-economic development across different regions. Subgroup analyses considered age, sex, year, geographical location, and SDI.

FINDINGS: From 1990 to 2021, the global deaths and DALYs attributable to high BMI increased more than 2.5-fold for females and males. However, the age-standardized death rates remained stable for females and increased by 15.0% for males. Similarly, the age-standardized DALY rates increased by 21.7% for females and 31.2% for males. In 2021, the six leading causes of high BMI-attributable DALYs were diabetes mellitus, ischemic heart disease, hypertensive heart disease, chronic kidney disease, low back pain and stroke. From 1990 to 2021, low-middle SDI countries exhibited the highest annual percentage changes in age-standardized DALY rates, whereas high SDI countries showed the lowest.

INTERPRETATION: The worldwide health burden attributable to high BMI has grown significantly between 1990 and 2021. The increasing global rates of high BMI and the associated disease burden highlight the urgent need for regular surveillance and monitoring of BMI.

FUNDING: National Natural Science Foundation of China and National Key R&D Program of China.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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